Last year, the Annals of Internal Medicine published the results of a survey (below) questioning if a physician who made an assertion about homosexual behavior on an Internet discussion site should be investigated…..60% of state licensing boards responded affirmatively.

Hmmm, what about in states where the population is overwhelmingly opposed to gay rights? Would you want the government to be able to investigate a physician for making a statement in favor of gay rights? That knife cuts two ways. We either have freedom of speech…or…we don’t.

Before a physician can even apply for a license the individual must have met college level prerequisites, completed a 4 year (or equivalent) medical college degree and completed a one year internship. That is a lot of hours of supervision. True, some physicians get through the licensing process and some eventually commit felonies and lose their license. The fact remains that the license can and is being used to control free speech. California physicians went all the way through the Federal Court system to fight for the right to discuss and recommend medical marijuana to their patients.Conant v._McCaffrey decision Now, many states have medical marijuana laws. Why do we try to control a medicinal herb that used to commonly be available and is much safer for chronic pain than narcotics? so the drug companies can keep physicians pushing their products and use the government to control their licenses.

there are libertarian think tank/legal foundations willing to look at licensing issues and I am willing to approach them.

I was the first speaker and my testimony begins after the first 4 minutes and extends for less than 10 minutes. While it has been 10 years since this event, I recall a question by Senator Jane Nelson that appears to be edited out and other information included that I doubt I stated. Unlikely I would recount my personal medical experiences for public viewing. I believe I mentioned William Dement MD by name while holding up his book as a reference.

I am reading an article in today’s San Francisco Chronicle titled “Brain-death battles” about the post surgical death of a 13 y/o American girl of African descent. As I read the description of the surgery as “Jahi’s tonsils and adenoids were removed, along with excess tissue from her throat and nose” I became very angry. This procedure is known as a UPPP* and was widely discredited years ago. I recall sending a patient for a consultation with an ENT physician and then realizing he had no improvement and basically moved home to the east coast to (mostly) retire. I saw a review of this procedure that followed many cases and unequivocally stated that persons with obstructive sleep apnea who had this procedure tended to do worse than patients who did not have the procedure. I eventually was diagnosed with obstructive sleep apnea resulting from a (supposedly) rare craniofacial birth defect and had extensive bone rearranging surgery on the mid and lower half of my face. Eventually I discovered that craniofacial anomalies were common in children of service men exposed to the nuclear testing environment, like my dad was. During the autopsy that must be performed on this child**, it would be important to have a forensic examiner who is familiar with the upper anatomy, since this anomaly could have been missed.

Oh, by the way, if you, John Q Public, are going to blame her (Jahi McMath) obstructive sleep apnea on her weight….there are lots of people who get obstructive sleep apnea as thin people, then get fat because of the wild cortisol swings and sleep obstruction, in large part because the obstructive sleep apnea is missed while they are thin and effective CPAP treatment initiated.

Our Americans with African origins population has sleep apnea about three times as prevalent as the Anglo population. It is a scandal of criminal proportions that this issue has not been more widely taught, researched, and the etiology discovered so that prevention,rather than misguided surgery, rules the day.

American Medical Association commits RICO violation? This was my original title , but this is jumping the gun as the actual perpetrators influencing and funding the project below needs investigation. Tim Bolen, of the Bolen Report, says that aetna insurance and Big Pharma was behind it, but as best I can find, this is “inside information”.

Tahoma Clinic has posted FSMB (Federation of State Medical Boards) report titled Special Committee on Questionable and Deceptive Healthcare Practices that is intended to prevent consumers (patients) from choosing holistic doctors. In this report “harm” does not mean injury but rather “economic harm” and they drafted third party players (like insurance companies!) to report physicians to licensing boards. I paraphrased another physicians comments and will find his name and post the credit.

Using the power of the state to suppress competition and there is an effort ongoing to trace Big Pharma and at least one insurance carrier to this act by the FSMB

By 1995, using German textbooks as a guide, I began using plant/botanical preparations to benefit my patients. Sometimes, there wasn’t a synthetic alternative that could do what flowers, roots, and mushrooms could do! By enacting this policy and pointing the government at our licenses, the ability of physicians to help you get well and avoid morbidity and mortality has been severely compromised. It very well may take eliminating the “right” of the government to license physicians to stop these practices. The vested interests will set up the physicians in so many different ways to compromise their ability to stay in practice otherwise. Bogus malpractice case anyone? I used to evaluate other physicians malpractice cases for an independent practice association. Now I am beginning to wonder if at least one of the cases I reviewed was set up to go after a physician (who was really a great physician) Really, I didn’t even like him, but he was a really great physician.

Below is the result of your feedback form. It was submitted by
(cynthia.jeanne.lee@gmail.com) on Wednesday, October 30, 2013 at 13:48:09
—————————————————————————

type: intake

FirstName: Cynthia Jeanne

LastName: Lee MD

profession: physician

phone: 415-592-2788

Fax: 415-592-2855

Address: 3rd Floor SWC, 150 Golden Gate Ave

City: San Francisco

State: CA

Zip: 94102

summary: I was involved in a civil case in Texas District court. A court appointed expert, without any competence or experience in my area of disability, was forced on me. The judge decided I was faking an impairment and forced me to turn over protected retirement funds to my lawyer for dispersal for legal fees and the “expert’s” fees. I filed in Federal court. The medical licensing board was now headed by the attorney I had previously retained who had failed to protect my rights in district Court. This board hastily filed on my right to remain licensed and eventually harassed my new attorney, while in the government buildings for a hearing, in to quitting. Efforts to approach the FBI about certain criminal aspects of the case, including U S mail disruption issues, resulted in my being stalked out of my home and having prolonged stays out of state, complicated by repeated stalking events. There was apparent interference with my income tax representation and, while out of sta!
te, my homestead was not protected and seized.After a lifetime of almost continuous work building a medical practice and assets to protect myself against disability and for retirement, I am left homeless and indigent.

explanation: The FBI refused to investigate and actually denied to my face that I had ever visited their offices to file a complaint.
U S mail inspectors never returned any requests for investigation.

government_motivation: I am outspoken about the issue of pharmaceutical industry control of my profession and its actions. There has been, for some decades, interference with the licensing of physicians who practice alternative medicine. There was overreaching by state judges for political reasons, as per the statements of the lawyers who failed to protect me in district court.
In the 2004 AMA handbook on HIPAA there was a statement that the government was reserving the right to keep information in the medical records of licensed professionals and simultaneously restricting the right of their physicians to share this information about them with them. Meanwhile, the government was asserting the right to share this information with, among other entities, police departments! This tactic would allow the government to assert that someone is a psychotic individual and not allow them to fight this assertion.

court_status: I have not been able to engage an attorney and most of the documents I produced attempting to do so have disappeared. Some of the remaining, I have placed on a blog, cynthiajeanneleemd.wordpress.com

CIR_should: I believe an investigation would show that, in order for me not to have a successful case in Texas that would limit the right of the judges to seize my retirement funds, among other abuses, federal assets were put into play resulting in Gestapo State tactics. I want legal representation that will protect the first amendment right to sue the government without retaliation.

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Yesterday (November 7th, 2013), around 4 PM PST, I submitted a request for an amicus to the mountainstateslegal.org Never heard about this libertarian legal foundation? Look it up. I was impressed that in a Texas case, they helped a psychologist defend her right to use this information about her training while running for an elected office when the licensing board objected. Freedom of speech! Hey, that is what my fight with the medical board of Texas is all about. Imagine, this board thought they could tell me not to diagnosis obstructive sleep apnea in my patients. Then, when I make an effort to sue them over this action, I get stalked out of my homestead. Well, homeless and indigent now but not without attitude!

Anyway, I digress, the mountainstateslegal.org has a policy that they do not acknowledge requests for legal assistance unless they decide to explore it further. This means, to me, that a Man in the Middle could review the requests and simply decide there was little risk in simply placing it into the shredder. Therefore, I sent the following comment to mountainstateslegal.org this AM around 9:11 or so.

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

subject: Submissions are not acknowledged with an automated reply, because?

Body of comment: I am curious why your foundation is so trusting that the government would allow all emails requesting legal assistance to reach your servers? An automated reply, documenting the content of the request received, lends legitimacy to your foundation. Especially, this is worrisome, because one is informed that the foundation will “then contact you if the potential exists to discuss representing you”. This leaves the situation wide open for governmental abuses. Surely, allowing an automated reply with appropriate documentation could not be so difficult.

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Readers are encouraged to urge this foundation to change their policy to one of acknowledging all requests. I also want to recommend they consider posting the information on court cases they would like to take but do not have the resources for in order to set up “crowd funding” to see if funds can be raised to pursue justice.

Why do I think the Man in the Middle would interfere? Think of my experiences approaching the Center for Investigative Reporting* a couple of years ago? They had an automated reply and I received one the first time I sent an idea to them (about the tactic of launching malpractice cases with the specific intent of pushing certain ideas into the practice of medicine while colluding with special interests to suppress other info). That automated email from the Center appeared to disappear so I sent the idea again. Hmmm, no automated reply this time. So, I went and tried to deliver the request in person in Berkeley…no go….they refuse to allow personal delivery…have to use only government approved means of delivery. Lance Williams (that lackey) came down in person to accept my written information. Maybe there was something to the criticism that his story on drug use in professional athletes came out just in time to “overshadow” far more important information in the news cycle?

Remember what I discovered when I sent registered mail to the ACLU offices in San Francisco? “F E L O N” signed for it! I subsequently attended an ACLU event…no one named FELON works there!

Mountain States Legal Foundation….don’t they represent polluters? Think it was politically incorrect to approach this foundation?

OK, Listen up all you environmentalists! Before you go ballistic….since I am making an approach to a legal foundation you consider your arch enemy….wouldn’t you like to see the waters of our country free of synthetic medicinals? I mean, neither you nor the fish really need Prozac (which is documented to be in the water affecting fish). The SSRI’s may also be associated with more mass shootings than any other type of synthetic medications.You know the style of medicine I advocate uses both science and common sense to dictate offering the safest medical advice to my patients….and that rarely would dictate the need for a synthetic compound. That is a potent reason why Big Pharma has arranged for alternative health (i.e. science based!)practitioners to be targeted so thoroughly for so many decades. So this foundation also represents oil producers. Do you think they want to see Prozac in the water their pregnant daughters drink? Creepy, isn’t it? What this stuff does to the brains of developing fetuses? I mean, who knows what it really does? And Prozac is not the worst of the chemicals finding their way into your drinking water (think MTBE!). In addition, the costs associated with these riskier strategies results in very high insurance costs that stifle small businesses. I’ve blogged on this before. This foundation wants to support small businesses and so do you. That’s why they should support my case (related to the rigging of health insurance costs) and you should too..

OK, so I tried to publish this and did not receive the automated response from wordpress.com documenting receipt of my new post (its only my 70th plus posting, for Pete’s sake)….hmmmm, now I am finding that the comment I tried to post from the submission this AM on the Mountain States Legal Foundation site doesn’t look like anything decipherable to a nontechnical person like me.(which I have now redacted along with other typos)….and…now the computer is giving me the option to correct spelling with the spell checker that it suddenly stopped doing this AM….three separate problems or all related? Hell if I know!

My approach to this issue, control of physician education and medical practices, allows me to reach out to many different interest groups.

If you would like to be a part of decreasing medical costs while relieving people of chronic renal failure and helping end the killing of political prisoners in China, help me or others set up educational actions at dialysis clinics. Dress up like one of the many healthy foods, full of minerals and vitamins, that are restricted from the diets of patients in renal failure and hand out copies of the research into coenzyme Q10 that has been documented to reverse some of the renal failure.

here is the info I give out below and here is the link to print out copies of this

The physician ignorance about obstructive sleep apnea has lead to the early demise of the elders of the Americans of African descent population. My efforts to leaflet on this situation in San Francisco led to an assault and battery by London Breed, a locally prominent American of African descent. The local bar association did not come through for me to pursue her legally. If you would like to go visit local political leaders with me to ask for an investigation by the government of how this (the early demise of elders secondary to undiagnosed untreated obstructive sleep apnea) has been allowed to happen, please let me know via cynthia.jeanne.lee@gmail.com

Also, we need an investigation into whether there exists greater chemical sensitivity in certain racial groups so that these chemicals can be outlawed sooner rather than later. Remember my assertion that research published over a decade ago by the University of Edinburgh demonstrated that, of newly diagnosed sleep apnea patients in Great Britain, half had a BMI of < 27. This strongly suggests that the obesity seen in many sleep apnea patients is the result of the sleep disruption and not the cause of the apnea. I discussed this previously in earlier posts.

I copied the email from Terry Pell of the Center for Individual Rights which documented their receipt of my request made via their website into a document on my google drive. Thus, anyone on the Internet can access this request. Can anyone think of a better system of documenting that the organization one is trying to access has received the request? Only one I can think of is to have the organization be allowed to post all requests received (with permission by the individual making the request). This would also be useful to receive feedback from supporters and hopefully, the funding necessary to take on cases that go down the rabbit hole. As far as I can tell, either the Man in the Middle grabbed my request to the Southern Poverty Law Center and to the ACLU or these organizations are (now) part of the problem, however much help they were in the past.

I am listing the family, friends and fellow physicians that were lost to me and I note how grateful I am to still be alive to continue the pursuit of justice for me and others who were misdiagnosed.

William Hart MD

Robert James Provan JD

Larry Mason Lee JD

Kathy Sheley Ph D

Joshua Carreon

legal writer who was to be contracted to write my suit against the medical board in 2005

wheel chair activist recommended by Robert Provan to help advocate for ADA rights in Texas courts (died per 2005 Internet postings), subsequently discovered to not have died when I found current writings from him in a journal dated 2006

I only recently became aware of the controversy over the deaths of two U S Attorneys investigating healthcare fraud involving the purchasing of hospital supplies. The situation began when an independent medical supplier found he was shut out of the market by a consortium of suppliers. Thelma Quince Colbert and Shannon Ross’s unexpected deaths deserved a thorough investigation.

Lee’s Summit, Missouri—May 10, 2007—Tom Flocco.com—According to Medical Supply Chain CEO Samuel Lipari who is suing hospital supply company Novation LLC, Missouri Democratic Senator Claire C. McCaskill knew that seven U.S. attorneys—two assistants who turned up dead, three assistants who resigned or were fired and two U.S. attorneys who were also forced out—had something in common: all seven were investigating Medicare and Medicaid fraud in the United States healthcare system involving overcharging for hospital supplies and medical fees amounting to billions of dollars in fraud.

Senator
Claire C. McCaskill
(D-MO)

Lipari’s suit against Novation has ties to the White House in that the President’s brother Jeb Bush joined the board of directors of Novation member Tenet Healthcare on April 12, 2007 and George W’s cousin’s company wrote software for hospital equipment global reference numbers, raising questions as to why Jeb Bush has become associated with a company involved in multiple lawsuits and fraud probes.

President Bush’s first cousin Jonathan Bush is CEO of Athena Health in Watertown, Massachusetts, the developer of Novation’s “CodeRyte” software program that “runs on an algorithm built into the system,” which “can read the data entry, find any required associations and automatically contact on-staff coders who can read the work and determine the appropriate code.”

Former Florida Governor Jeb Bush’s association with Novation’s Tenet Healthcare comes after Tenet was audited in 2004 by the California Department of Health Services after overcharging the state’s Medicaid program, Medi-Cal, by $11.9 million at Redding Medical Center, linked to a Tenet probe by fired San Diego U.S. Attorney Carol Lam, a 45-agent FBI raid and multiple subpoenas signed by a Dallas assistant U.S. attorney found dead the day before Senate healthcare anti-trust hearings.

San Diego and Memphis papers reported that Tenet Healthcare Corporation of Dallas has agreed to pay $21 million as part of a civil settlement with the federal government over allegations of kickbacks to doctors. The settlement also requires Tenet to close or sell the hospital where the kickbacks allegedly took place, Alvarado Hospital Medical Center in San Diego.

The settlement averts a third criminal trial over an alleged kickback scheme between 1992 and 2002 to pay doctors for referring patients to Alvarado. Two previous trials, in 2004 and 2005, ended in deadlocked juries.

Samuel Lipari

“The implication for fraud involving hospital equipment costs, multiple fee structures and insurance claims is quite high,” alleged Lipari, after we told him that Novation was one of the first in the healthcare group purchasing industry to endorse Athena Health and Jonathan Bush’s CodeRyte Global Locator Numbers (GLN) which are 13-digit reference numbers used to identify legal entities such as registered hospitals, specific hospital departments, warehouses or particular rooms or beds in a hospital.

U.S. intelligence sources allege that electronic medical coding can be manipulated to over-bill or essentially defraud the U.S. healthcare system in the same manner as election fraud activists have proven that electronic voting machines can be manipulated to fix U.S. elections, but also vote counts in foreign countries such as last week’s French national election.

A highly placed U.S. intelligence agent was asked to inquire among other federal insiders as to the full extent of healthcare fraud over the last ten years, after which the agent later said, “Intelligence officials in a position to know have estimated the real dollar figure to be about $ .5 trillion in stolen Medicare and Medicaid funds,” adding, “healthcare entities have defrauded the United States government to the extent that the whole system faces either bankruptcy or hyper-inflated costs.”

Senate Judiciary obstruction of justice

The Senate Judiciary Committee failed to question Attorney General Gonzales about the two suspicious deaths and three abrupt departures of assistant U.S. attorneys at the Dallas-Fort Worth U.S. Justice Department (DOJ) offices all within 90 days during an $84 billion Medicare fraud probe.

California’s Redding Medical Center is one of thousands of U.S. hospitals, nursing homes and clinics subject to the far-reaching Justice Department Medicare fraud probe researched by Fort Worth Civil Enforcement Head Thelma Colbert which resulted in multiple subpoenas signed by her boss, Dallas U.S. Attorney’s office Criminal Chief Shannon Ross—after which Ross was found dead on September 13, 2004, the day before Senate hearings on healthcare anti-trust violations—and just 55 days after Colbert turned up dead in her swimming pool on July 20, 2004.

The Senate Judiciary Committee also failed to interrogate Gonzales about circumstances involving the quick departures (35 days after Ross’ death) of three assistant U.S. attorneys in Colbert’s Fort Worth office—Leonard Senerote, Michael Uhl and Michael Snipes—and whether the Attorney General had them fired, forced them to resign or they were intimidated by the deaths of Colbert and Ross.

Given recent lengthy prison terms for several high corporate executives, the stakes are obviously high in a healthcare fraud case with ties to the White House; but were the stakes high enough to necessitate decimating the whole civil fraud unit in Dallas-Fort Worth?

The Democratic Senate Judiciary majority failed in its oversight by never questioning the Attorney General as to why he covered up the Colbert and Ross deaths, and why Lipari’s Medicare fraud probe and the Dallas-Fort Worth subpoenas have been derailed, essentially going nowhere.

No U.S. legal entity has questioned whether McCaskill or Leahy obstructed justice in the Senate’s Gonzales hearing under 18 United States Code 4 guidelines for reporting federal crimes, or whether meritorious evidence that the White House purposely quashed the Texas fraud case was also covered up, despite deaths and firings within a compact timeline.

It is not known whether the Dallas-Fort Worth subpoenas or Lipari’s Novation suit have been totally disrupted; but the Redding Medical Center findings indicate that a probe into electronic medical coding manipulation potentially linked to Medicare and Medicaid over-billing should be ordered by Congress to protect Medicare and Medicaid for America’s seniors.

Last Thursday we talked to Senator McCaskill’s deputy chief of staff Dana Postar who said, “We will get back to you with a statement regarding the disposition of Mr. Lipari’s case and any investigation into his charges,” after we told her about the first two stories at TomFlocco.com.

The previous week we also talked to McCaskill’s press spokesperson Maria Speiser who told us, “We never received Mr. Lipari’s letter but I know about the case,” to which Lipari replied, “Senator McCaskill has the letter. In the presence of my attorney, I signed their ‘privacy waiver” seeking my signed permission for her office to commence an investigation of my case which we mailed to Sen. McCaskill’s office.”

While neither staffer has called us back with a statement, Sam Lipari told us that “Cory from Senator McCaskill’s constituent services staff called me on May 1, the day after your second story was posted online, asking ‘What can we do to help you?’ “

“Maybe Sen. McCaskill will question the Gonzales cover-up of the deaths and firings in Texas and help get my case back in gear,” said Lipari, adding, “her office also sent me another privacy waiver for an FBI investigation.”

Today the House Judiciary Committee will have the opportunity to question Mr. Gonzales.

We have a feeling that the questions for the Attorney General on Thursday morning will be somewhat tougher.

Maybe Chairman John Conyers will actually ask Gonzales what he knows about the five dead and fired U.S. attorneys probing Medicare fraud in Dallas Fort Worth and perhaps he will attempt to get to the bottom of Sam Lipari’s case.

The Bush-Clinton crime families have already stolen enough taxpayer funds from the U.S. Treasury; so it is hoped that the People’s House of Representatives will prevent further looting of Medicare and Medicaid funds so that America’s seniors will continue to be afforded proper medical care in their old age.

Federal whistleblower Mary Schneider contributed additional research for this report.

Here is the article as found on the Masimo company page on October 19, 2013 and it kind of makes those investigations and prosecutions of fraudulent behaviors by clinics (fly by night and otherwise) look like small potatoes by comparison :

August 21, 2004

Wide U.S. Inquiry Into Purchasing for Health Care

By MARY WILLIAMS WALSH

The Justice Department has opened a broad criminal investigation of the medical-supply industry, apparently to determine whether hospitals and other medical care providers are fraudulently overcharging Medicare and other federal and state health programs for a wide array of goods – from rubber gloves to drugs to X-ray machines.More than a dozen medical-supply companies recently received federal subpoenas in what appears to be a wide-ranging investigation into the way suppliers market products to clinics, hospitals and nursing homes that serve Medicare and Medicaid patients, and whether those institutions properly account for the purchases.Industry executives expect many hospitals to receive similar requests in coming weeks.The central issue, according to current and former industry executives, is whether the industry’s use of rebates, discounts, barter arrangements and refunds to hospitals and other medical centers means that Medicare and Medicaid are being charged higher prices for products than the hospitals are actually spending.

The investigation appears to be centered on the medical-supply industry’s dealings with Novation, a company in Irving, Tex., that is an industry leader in negotiating the contracts that thousands of hospitals, clinics, nursing homes and other facilities use to buy drugs and other supplies.

About $20 billion a year in medical products and services are sold under contracts arranged by Novation, which is owned by about 2,200 of the hospitals and care centers that use its services. They include well-known medical centers like New York- Presbyterian Hospital, Yale-New Haven Health Services and Baylor Health Care System in Dallas.

Because Novation is the link between thousands of health facilities on one side, and hundreds of medical goods and services companies on the other, the scope of the federal investigation appears to be broad.

A Novation official confirmed this week that the company was recently served with a federal subpoena demanding that it produce documents.

“This matter is in the very early stages,” Novation’s senior vice president, Jody Hatcher, said in an e-mail reply to a reporter’s questions. “Novation will fully cooperate with the U.S. attorney’s office to provide the requested documents.” Mr. Hatcher did not characterize the type of documents sought.

Mr. Hatcher also cautioned against drawing any inferences from the subpoena’s references to various sections of the United States Code that deal with health care offenses.

“These subpoenas can be issued without any finding of misconduct,” he said. “It would be misleading to state or imply that Novation, or any of its constituents or vendors, has violated any of the statutes you referenced.”

Hospitals and clinics are financed with public money to a great degree, through programs like Medicare that reimburse many of the costs they incur in treating patients. If a hospital submits an erroneous cost report to Medicare, it can receive a larger reimbursement than it is due. If this is done knowingly, it can constitute Medicare fraud, which can carry fines and a 10-year prison sentence.

The federal investigation came to light after one medical products company, Becton, Dickinson, disclosed last week in its quarterly financial report that it had been served with a subpoena. Becton, Dickinson, the world’s largest maker of medical needles and syringes, said in the report that it believed its transactions with Novation had “fully complied with the law,” that it would cooperate and that it was not currently a target of the investigation.

Some of the other big companies to be served with subpoenas are the drug makers Merck, Bristol-Myers Squibb and Genentech; the G.E. Healthcare medical equipment unit of General Electric, and Cardinal Health, a big manufacturer and distributor of drugs and medical supplies.

Based on the federal codes cited in a copy of one of the subpoenas, investigators are seeking evidence of health care fraud, conspiracy to defraud the United States, theft or bribery involving programs receiving federal funds, obstruction of investigations and other possible violations. The subpoena was signed by Shannon Ross, criminal chief of the United States attorney’s office in Dallas.

A spokeswoman for that office declined to discuss the subpoenas or to confirm that an investigation was in progress, citing longstanding policy. Most of the companies also declined to discuss the matter, other than to say that they would cooperate with investigators.

Novation’s primary business is to pool the purchasing volume of about 2,200 hospitals, as well as thousands of nursing homes, clinics and physicians’ practices, and to use their collective power to negotiate contracts with suppliers at a discount. In many cases, the contracts offer special rebates to hospitals that meet certain purchasing targets. Although Novation is not well known outside the industry, it wields formidable power because it can open, or impede, access to a vast institutional market for health products.

Novation’s business practices, which were the subject of an investigation in 2002 by The New York Times, have drawn criticism from several parties , including the antitrust subcommittee of the Senate Judiciary Committee. The practices under scrutiny include questionable payments in the awarding of contracts and incomplete accounting of the rebates paid to hospitals and other medical centers.

The chairman and ranking member of the subcommittee, Mike DeWine, Republican of Ohio, and Herb Kohl, a Wisconsin Democrat, have been monitoring Novation and other companies involved in the group purchasing of health products. In hearings, they have expressed concerns about possible abuses and have publicly called on companies in the industry to adopt heightened ethics policies or risk tighter regulation. The subcommittee is expected to hold another hearing on the issue next month.

Novation has also been attacked by other companies, in past testimony to the subcommittee and through civil suits brought by small medical suppliers that accused it of freezing them out of a big share of the market for medical products. But until now, Novation was not known to have been named in a criminal investigation.

In July, Becton, Dickinson, paid $100 million to settle a lawsuit in which a smaller needle manufacturer accused it of working with Novation and other purchasing companies to freeze competitors out of the institutional market. Becton, Dickinson denied any improper behavior in that case, saying it settled to avoid protracted and costly litigation.

A spokesman for Premier Inc. of San Diego, the nation’s second-largest hospital purchasing company, said that Premier had not received a subpoena. Novation was created in 1998 as a joint venture of two networks of nonprofit hospitals, VHA Inc. of Irving, Tex., and University HealthSystem Consortium of Oak Brook, Ill. The two networks are cooperatives that also provide services like consulting and data analysis for their members.

VHA, the larger of the two networks, holds the larger stake in Novation. It is composed of about 1,400 nonprofit hospitals – about one-fourth of the nation’s total – and 800 other health facilities. Many of its members are small and relatively obscure, but some are large and well known. Besides New York-Presbyterian, Yale-New Haven and Baylor, they include Massachusetts General Hospital in Boston and the University of Pennsylvania Health System in Philadelphia. A spokesman for VHA referred questions about the investigation to Novation.

University HealthSystem Consortium is much smaller than VHA but consists of many prestigious teaching and research hospitals, including Johns Hopkins Hospital, N.Y.U. Medical Center, Mount Sinai Medical Center and various facilities of the State University of New York. Its hospitals are considered an extremely attractive market by suppliers, because they tend to perform unusual procedures and buy more high-end devices.

An official of University HealthSystem Consortium said that the organization had not been subpoenaed but that the consortium “would assist Novation in responding to the subpoena that they have received.”

People in the medical-supply business who were aware of the subpoenas said the investigators wanted records of payments made by suppliers to Novation and to the hospitals and other facilities that use its contracts.

“It’s about the money, and you’ve got to be able to track where the money goes,” said a former Novation executive, who would discuss Novation’s operations only anonymously because he was “concerned about being completely blackballed” in the industry.

The executive said he had been contacted by an investigator from the Department of Health and Human Services’ Office of Inspector General, who asked for the same type of information the Justice Department is seeking: the nature of the payments that suppliers make to Novation, how Novation picks which companies will be awarded contracts and what Novation does with the payments it receives from suppliers.

In most cases, suppliers are not permitted to make gifts or payments to purchasing agents for health facilities that receive Medicare money, because of the risk that some might offer kickbacks in their efforts to win business. But Novation operates within a “safe harbor” of the anti-kickback law, created specially for hospital purchasing groups.

The provision allows Novation to accept payments from suppliers with no legal consequence, as long as those payments do not exceed the safe-harbor limit, which is 3 percent of the suppliers’ sales through Novation’s contracts.

Over the years, these payments have become customary in the business. They are called administrative fees, because they are supposed to cover the cost of administering the contracts.

But industry records show that some companies have made other types of payments to Novation as well, and the total payments have sometimes exceeded the safe-harbor limit, sometimes surpassing 10 percent. Companies also contribute seed money to various initiatives and programs conducted by Novation’s parent, VHA, and to a related foundation, the VHA Health Foundation, which finances health-delivery projects undertaken in VHA hospitals.

Because businesses set up as cooperatives are barred from retaining capital, Novation and its two parent companies are required each year to distribute all of these payments to their member hospitals, after subtracting operating expenses. Those yearly distributions, as well as the rebates to hospitals that meet their purchasing contract targets and certain in-kind contributions, effectively lower the hospitals’ purchasing costs.

But because Novation is not publicly traded, there is no public accounting of these distributions. Some of the distributions are not made in cash, meanwhile, but in coupons that hospitals can use to purchase consulting services from VHA.

Hospital officials say privately that the complexity of these flows of funds makes it next to impossible to state the true costs of the drugs and other supplies they purchase each year, when they report their expenses to Medicare.

The former Novation executive said he believed that the federal investigators might see similarities in those arrangements to payments that drug companies have made to doctors who prescribed their brands – payments that have led to multibilliondollar settlements by some pharmaceutical companies.

“Pharmaceuticals are referred to in the press because the average reader can associate with them more,” the former executive said. “Consumers don’t buy operating-room tables or X-ray machines, or that kind of stuff, but you’ve got the same sort of thing going on. And it’s huge, huge money.”

Sam Haskell buys movie rights toFall of the House of Zeus

Sam Haskell, now an Oxford resident and previously the head of the television division of the William Morris Agency, has bought the movie rights to Curtis Wilkie’s Fall of the House of Zeus, according to this story in Variety:

Former WMA TV topper Sam Haskell is going to court, acquiring film and TV rights to Curtis Wilkie’s tome “The Fall of the House of Zeus: The Rise and Ruin of America’s Most Powerful Trial Lawyer.”…

Haskell’s memoir “Promises I Made My Mother” was published last year. He’s had book signings in more than 100 cities and traveled to Afghanistan to take the book to U.S. soldiers through the Department of Defense.

I read the advance copy of Curtis Wilkie’s book. I was struck by the fact Dickie Scruggs had back to back back surgeries, within 60 days. I have never heard of anyone having back surgery twice in such a short time frame in my short twenty two years of active practice (except patients with infections). Could the physician have deliberately hurt him in order to set him up for drug addiction? Mr. Scruggs used to take medical malpractice cases. The insurance companies are devious. In Texas, they used the physicians to help lobby the public to get a change in the state constitution to get a cap on punitive damages. I believe they would be capable of leaning on a physician to help them out since Mr. Scruggs was such a feared litigator. Anyone could have been rendered susceptible to narcotics abuse with sufficient medical mismanagement. Anyone under the influence, as Mr. Wilkie suggested he was by every afternoon, could have made an inaccurate or careless statement.

Dickie Scrugg’s son, also a lawyer, got caught up in this case, went to prison, and lost his license. He has subsequently discovered that his own attorney was cooperating with the prosecution behind his back. he is suing for a reversal of the conviction.

I went by the office of his defense attorney and left information that this physician was baffled about why his addiction issues were not explored and addressed first.

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Physician activist on the First Amendment Rights of your physician, the Americans w Disabilities Act as it applies to the right to receive accurate diagnosis instead of psychobabble. Interest in stopping the death penalty by showing that forensic psychiatrist/psychologists are IGNORANT of KEY areas of MEDICINE as it impacts behavior